• 제목/요약/키워드: cysts

검색결과 1,191건 처리시간 0.035초

Surgical Experience of Transsphenoidal-Supradiaphragmatic Intradural Approach to Presellar and Suprasellar Lesions

  • Park, Min-Woo;Kim, Jae-Min;Kim, Jae-Hoon;Bak, Koang-Hum;Kim, Choong-Hyun;Jeong, Jin-Hyeok
    • Journal of Korean Neurosurgical Society
    • /
    • 제39권5호
    • /
    • pp.329-334
    • /
    • 2006
  • Objective : In selected cases, the transsphenoidal approach[TSA] can be extended anteriorly to the tuberculum sellae, chiasmatic sulcus, and planum sphenoidale to obtain direct exposure of the suprasellar cisterns and its contents. We applied this modification of the TSA to various lesions of the presellar and suprasellar areas. We evaluate our clinical experience of this technique and review the related literature. Methods : From 1999 to 2004, we used the transsphenoidal supradiaphragmatic intradural approachs[TSIAs] in 9 patients who had various lesions at the pre- and suprasellar regions. Concomitant presellar extension of the bone window was performed with the sublabial or transnasal transseptal transphenoidal techniques. After removal of the lesions, sellar or anterior cranial floor was repaired with silicone plate substitute. Results : The TSIAs have been applied in the following cases : four tuberculum sellae meningiomas, two craniopharyngiomas, two Rathke's cleft cysts, and one non-functioning macroadenoma. The complications were one case of visual acuity decrease and one cerebrospinal fluid rhinorrhea. Conclusion : The TSIA is easily applicable through a minor modification of the standard TSA. It is suitable for removing lesions located in the presellar and suprasellar area adjacent to the pituitary stalk with minimal brain manipulation and decreased morbidity.

이차성 삼차신경통에서 경피적 고주파 삼차신경절제술에 의한 동통조절 효과 (Effect of Pain Control with Percutaneous Radiofrequency Rhizotomy in Secondary Trigeminal Neuralgia)

  • 강승범;손병철;김문찬;강준기
    • Journal of Korean Neurosurgical Society
    • /
    • 제29권1호
    • /
    • pp.66-71
    • /
    • 2000
  • Objective : There are many treatment modalitis in management of idiopathic trigeminal neuralgia. In the secondary trigeminal neuralgia, there has been only sporadic reports of the etiology. Authors report the treatment result of secondary trigeminal neuralgia with percutaneous radiofrequency rhizotomy. Methods : During last ten years, 129 trigeminal neuralgias were treated by percutaneous radiofrequency(RF) rhizotomy by authors. Among them, nine patients were secondary trigeminal neuralgias. These patients refused treatment for the primary cause and only wanted pain control. The offending lesions were three arachnoid cysts, six tumors. The mean age was 47.8 years and the mean duration of follow-up was 6.2 years. The right V2,3 distribution was most prevalent area of pain. Authors used the conventional Hartel's anterior approach and straight electrode for RF lesion generation. Result : The early result was satisfactory. Eight of nine patients became free of pain and one patient needed minimal dose of carbamazepine. The overall pain control was 100%. There was no mortality or morbidity for initial RF rhizotomy. During follow-up, four patients showed recurrence of pain(44%). Among these, two underwent repeated RF rhizotomy and became free of pain. The other two were controlled with medical management. Conclusion : These results indicate that the percutaneous RF rhizotomy is effective means of pain control. Overall recurrence was somewhat higher than that of idiopathic trigeminal neuralgia. Even with recurrence, however, repeated RF rhizotomy seems to be effective method of control of pain in these cases.

  • PDF

터어키안 저부 재건술시 실리콘 판의 유용성 (Usefulness of Silicone Plate for Sellar Floor Reconstruction)

  • 김승범;김재민;이형중;백광흠;김충현;오석전;이승환
    • Journal of Korean Neurosurgical Society
    • /
    • 제29권9호
    • /
    • pp.1204-1208
    • /
    • 2000
  • Objectives : At the closure of the transsphenoidal approach(TSA), the proper sellar floor reconstruction plays an important role in preventing postoperative complications. The septal cartilage, perpendicular plate of nasal septum, and the sphenoid sinus bone are usually used to repair the sellar floor as a bone splint. The authors evaluate the usefulness of a silicone plate as a substitute for bone splint to close a defect of the sellar floor. Materials and Methods : A silicone plate was used to repair the sellar floor in 7 patients with sellar lesions which included four pituitary adenomas, two Rathke's cleft cysts and one metastatic tumor. Among seven cases, five cases underwent a standard TSAs and two received a extended TSAs. The trajectories of the approach were sublabial in four cases and endonasal routes in three cases. The silicone plate for implantation was cut to a size of slightly larger than that of bone window and inserted with a three-pronged fork, and then adjusted precisely. Results : In six patients, there were no complications which related to sellar floor reconstruction. A postoperative cerebrospinal fluid(CSF) rhinorrhea was observed in one patient with pituitary macroadenoma. Conclusions : From the authors' experience, the advantages of the silicone plate are its simplicity of molding to fit any size of sellar floor defects, and easy detection of previously created bone window at reoperation.

  • PDF

대합에 기생하는 흡충유 유충의 연구 (STUDIES ON THE TREMATODE LERVAE INFECTED IN THE HARD CLAM, MERETRIX LUSORIA)

  • 전세규;이종백
    • 한국수산과학회지
    • /
    • 제9권1호
    • /
    • pp.35-42
    • /
    • 1976
  • 1974년부터 1975년 말까지 부안만 대합에 기생하는 흡충류 유충의 발육, 기생율, 조직변화 및 사육실험을 통하여 대합의 폐사원인을 밝혔다. 1. 대합의 생식소, 중장선, 새엽에 기생하는 유모 cercaria인 Cercaria pectinata Huet와 그 sporocyst를 검출하였다. 2. 기생충의 수와 량이 급히 증가하므로 흡충류에 기생된 대합은 기능장해를 받아 폐사된다. 3. 부안산 대합 2,639개체에 대한 대합에 기생되는 흡충의 평균 기생율은 $13.2\%$였는데, 월별로 보면 7월이 가장 높았으며$(29.6\%)$, 3월이 가장 낮았다$(2.0\%)$. 한편 각장에 관계없이 기생율은 거의 같았다. 4. 흡충류에 기생된 대합의 생식소는 거세되고, 유충의 증식으로 중장선은 압박을 받으며 새판내에 기생되므로 혈액순환장해를 일으킨다. 5. 수조 내에서 사육한 기생패는 35일만에 전부 폐사했다.

  • PDF

당사(當社) 종합건강진단(綜合健康診斷)센터에서 실시(實施)한 수진자(受診者)의 통계학적관찰(統計學的觀察) (Statistical Study on the Results of Daehan Life's Mediscreen(Human-dock))

  • 김병극
    • 보험의학회지
    • /
    • 제4권1호
    • /
    • pp.24-37
    • /
    • 1987
  • During the period from september, 1985 to september, 1986, 1,005 cases(475cases in male, 529 cases in female) of employees and family member were observed for the general physical examination(Human-dock) in Medical Department of Daehan Life Insurance Co. Ltd. The results were as follows. 1) The occurrence of obesity cases were observed as 130 cases(12.9%), and among the 130 cases, 34 cases(26.2%) were male and 96 cases(73.8%) were female. 2) Diabetes mellitus patients were detected as 93 cases(9.3%), and 53 cases(57.1%) were male and 40 cases(43.0%) were female. The most frequent age groups were demonstrated in age of 5th and 6th decades. 3) Hypertension patients were 85 cases(8.5%), and among the 85 cases, 42 cases (49.4%) were male and 43 cases(50.6%) were female. The most frequent age groups were 5th and 6th decades, and complication of hypertensive retinopathy revealed 54 cases(63.5%). 4) Hyperlipidemia cases were observed as 71(7.1%), and 42 cases(59.2%) were male and 29 cases(40.8%) were female. The most frequent age groups were 5th and 6th decades. 5) 69 cases(6.9%) of positive reaction of HBs Ag and 46 cases(4.6%) of abnormal erectrocardiography were detected in the total examination cases. 6) Abnormalities of liver function were observed as 58 cases(5.8%), and 46 cases(79.3%) were male and 12 cases(20.7%) were female. In ultrasonographic study, 25 cases of fatty liver were obtained in the abnormality cases of liver function. 7) Cholelithiasis and gastroduodenal ulcer patients were detected as 2 cases(2.0%) respectively. 8) In the total examination cases, pulmonary tuberculosis, positive reaction of syphilis and renal cysts(ultrasonography) were obtained as 9 cases(0.9%), 7 cases(0.7%) and 4 cases(0.4%) respectively. 9) In the total examination cases, gastric cancer and liver cancer patients were detected as 2 cases(0.2%) respectively.

  • PDF

종격동 종양과 낭종의 임상 경험 (Clinical Experience of Mediastinal Tumors and Cysts)

  • 최준영;옥창대
    • Journal of Chest Surgery
    • /
    • 제30권7호
    • /
    • pp.708-712
    • /
    • 1997
  • 경상대학교 의과대학 흉부외과학 교실에서는 1988년 4월부터 19%년 3월까지 47명의 원발성 종격동 종양 및 낭종 환자에 대하여 수술적 치험을 하였다. 환자들의 연령분포는 5세에서 67세로 평균연령은 36.4세였곡 남녀의 성비는 1:1.5였다. 임상증상은 홉통이(27.7%) 가장 많았고, 안검하수(14,9%), 전신쇠약(12.8%), 기침 (10.6%) 복시(10.6%) 등의 순이먼으며 증상이 없는 경우도 8례(17.0%) 있었다 종양의 위치는 전상부 종격동 이 63.8%로 가장 많았고· 술후 병리조직학적 진 단상으로는 흉선종(32.9%)이 가장 많았으며 낭종(21.3%), 신경 절 종잉(17.0%) 배아세포종(12.8%), 간엽종양(6.4%) 순의 빈도를 보였다. 수술시 양성종양 41례와, 악성종양 6 례중 3례는 완전절제가 가능하였으나 나머지 3례는 부분절제만이 가능했고 술후 6례 모두에서 화학요법 또 는 방사선요법을 시행하였다. 술후 합병증으로는 Homor 증후군, 유미흉, 상대정맥 파열, 그리고 횡격막 신경 마비 등이 각각 1례씩 발생하였으며 술후 사망례는 없었다.

  • PDF

고립골낭에 관한 X선학적 연구 (A RADIOGRAPHIC STUDY OF SOLITARY BONE CYSTS)

  • 김경락;황의환;이상래
    • 치과방사선
    • /
    • 제24권1호
    • /
    • pp.95-105
    • /
    • 1994
  • The aim of this study was to evaluate the clinical, radiographic and histopathologic features of 23 cases of solitary bone cyst by means of the analysis of radiographs and biopsy specimens in 23 persons visited the Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University and Chunbuk National University. The obtained results were as follows; 1. The incidence of solitary bone cyst was almost equal in males(52.2%) and in females(47.8%) and the prevalent age of the solitary bone cyst were the second decade(47.8%) and the third decade (21.7%). 2. In the signs and symptoms of solitary bone cyst, pain or tenderness revealed in 17.4%, swelling revealed in 13.0%, pain and swelling revealed in 21.7%, paresthesia revealed in 4.4% and 43.5% were asymptom and the tooth vitality involved in the solitary bone cyst, 76.5% were positive and 23.5% were either positive or negative. 3. In the location of the solitary bone cyst, 47.8% present posterior region, 21.7% present anterior region, 21.6% present anterior and posterior region, 4.4% present condylar process area. 4. In the hyperostotic border of the solitary bone cyst, 47.8% were seen entirely, 21.8% were seen partialy, and 30.4% were not seen. 5. In the change of tooth, 59.1% were intact, 18.2% were loss of the alveolar lamina dura, 13.6% were root resorption 4.55% were tooth displacement, 4.55% were root resorption and tooth displacement. 6. In the change of cortical bone of the solitary bone cyst, 39.1% were intact and 60.9% were thinning and expansion of cortical bone. 7. In the histopathologic findings of 9 cases, 33.3% were thin connective tissue wall, 11.1% were thickened myxofibromatous wall, 55.6% were thickened myxofibromatous wall with dysplastic bone formation.

  • PDF

초음파에서 족부 결절종으로 오인한 유사 병변 (Ganglion-like Lesions of the Foot on the Ultrasonography)

  • 천경아;신동환;서동현;;서진수
    • 대한족부족관절학회지
    • /
    • 제14권2호
    • /
    • pp.169-172
    • /
    • 2010
  • Purpose: The authors have experienced various lesions that simulate ganglion of the foot on the ultrasonography. The purpose of this study is to evaluate ultrasonographic findings of soft tissue lesions, which were interpreted as ganglion but confirmed as different lesions in the foot. Materials and Methods: We reviewed a database of patients with ganglion on the ultrasonography from two different institutions. There were 109 patients who underwent both ultrasonography and surgical confirmation. Twenty one lesions were identified, of which initial interpretation on the ultrasonography included ganglion which pathology revealed to be different lesions. All images were evaluated by one musculoskeletal radiologist, regarding size, margins, internal echogenicity of lesions, and presence of posterior enhancement. Results: Of 21 lesions, there were 6 fibrous tumors including fibroma, giant cell tumor of tendon sheath, and fibromatosis, 3 hemangiomas, 2 epidermal inclusion cysts, 2 chondromas, 2 angioleiomyomas, 1 trichilemal cyst, 1 neurofibroma, 1 granular cell tumor, 1 neurilemmoma, 1 neuromyxoma, and 1 nodular hidradenoma. Mean size of the lesion was 1.1 cm. Margins were smooth in 10, mild lobulation in 8 and marked lobulation in 3 lesions. Lesions were hypoechoic in 16, anechoic in 4 and isoechoic in 1 case. Posterior acoustic enhancement was definitely present in 5 lesions. Conclusion: On the ultrasonography, various soft tissue lesions of the foot may be confused with ganglion. During surgical resection care should be given even to a simple ganglion as it might turn up to be a solid lesions such as fibrous tumors.

신생아 담관 낭종의 수술 필요성에 대한 고찰 (Is Early Excision of Choledochal Cyst in Neonate Necessary?)

  • 김현영;이혜승;이성철;정성은;박귀원;김우기
    • Advances in pediatric surgery
    • /
    • 제11권1호
    • /
    • pp.19-26
    • /
    • 2005
  • Choledochal cysts have been associated with complications such as cholangitis, pancreatitis, and malignancy of the biliary tract. Recently, the incidence of choledochal cyst in neonate and young infant is increasing due to advances in diagnostic imaging. The aim of this study is to investigate the rationale of excision of choledochal cyst during the neonatal period. The clinical outcome and correlation between age at surgery and the degree of liver fibrosis were reviewed retrospectively. A total of 198 patients with choledochal cyst who were managed surgically between January 1985 and December 2000 at the Department of Surgery, Seoul National University Children's Hospital were included in this study. The overall outcome and the outcome of patients who were managed surgically during the neonatal period were compared. Correlation between age and the degree of liver fibrosis was evaluated by chi-square test and Pearson exact test. The mean age of the patients was 2 years 7 months (ranged from 5 days to 15 years). Mean postoperative follow-up period was 7 years 1 month (7 months to 20 years). The results are as follows. Twelve patients (6%) had postoperative complications, cholangitis (7), bleeding (4) and ileus (1). Eleven patients operated during the neonatal period had no postoperative complications. The positive correlation between age group and degree of liver fibrosis was statistically significant (chi-square: p=0.0165, Pearson exact test: p=0.019). The results support the rationale that excision of choledochal cyst can be performed safely without increasing morbidity in neonates.

  • PDF

Chondroid Syringoma on Face

  • Min, Kyung Hee;Byun, Jin Hwan;Lim, Jung Soo;Lee, Hye Kyung;Lee, Won Mi;Joo, Jong Eun
    • 대한두개안면성형외과학회지
    • /
    • 제17권3호
    • /
    • pp.173-175
    • /
    • 2016
  • Chondroid syringoma is a rare mixed tumor of the skin which is composed of both mesenchymal and epithelial cells. Its incidence at less than 0.1% and is frequently located on the head and neck. Chondroid syringoma is easily confused with epidermal cysts. Since malignant forms of chondroid syringoma have been reported, accurate and timely diagnosis is important for proper management. We report clinical and histological features of chondroid syringoma in 5 patients treated at our institution. In most of the cases, chondroid syringoma presented as a round, firm, nodular or cystic lesion that had well marginated heterogeneity in sonography. Clinically, all of the lesions were removed by simple excision. Microscopically, all five tumors were well circumscribed and consisted of epithelial, myoepithelial, and stromal components. The epithelial component formed tubules lined by one or more rows of eosinophilic epithelial cells. The outer layer of tubules appeared to be flattened myoepithelial cells. The stroma is myxoid and contained spindle shaped myoepithelial cells. We expect that the clinical, sonographic, and histological data from our report may help clinicians who are confronted with various kinds of analogous facial lesions to decide the most proper management for their patients.